Veterinary giants use artificial intelligence to read x-rays

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Artificial intelligence is increasingly helping veterinary professionals interpret radiographs, whether they were taken in a specialty, emergency or general practice.

The world’s two largest veterinary hospital owners are beginning to use artificial intelligence to read radiographs, suggesting that the adoption of new technology may be approaching a tipping point. This does not necessarily mean that radiologists will be unemployed. Companies expect that AI is more likely to help them do their jobs than replace them, at least for the foreseeable future.

Mars Inc., which owns more than 2,500 veterinary practices worldwide, is using artificial intelligence to interpret radiographs in about 60 practices as part of a pilot exercise, executives at Antech’s veterinary diagnostics division told VIN News Service. The AI ​​for McLean Group, Virginia, is developed in-house by Antech and is being trialled in practices in Europe, including the UK and North America. No company-wide rollout dates have yet been set.

Meanwhile, Bristol-based IVC Evidensia, which has more than 2,300 practices in Europe and Canada, has made further progress: it has completed a trial of an AI product developed by the American company SignalPET. The product is already in dozens of Canadian IVC Evidensia practices, and is expected to be completed UK-wide in about 12 months, closely followed by mainland Europe.

The software’s tools use artificial intelligence to read radiographs, known as X-rays, and provide an interpretation within minutes. Users access the software by logging into a website, and they can pay $10 per explanation. Other companies that provide technology to veterinarians include Vetology and MetronMind, both of which are located in California.

AI is used to interpret radiographs in human medicine as well, although mostly in academia due to higher regulatory hurdles than veterinary medicine and push back From some radiologists who fear the technology may not be ready for clinical use. At least one product has been released for standalone use in humans: In March, a product artificial intelligence tool To read chest x-ray images have been approved by European regulators.

Adoption appears to be happening more rapidly in the veterinary field at the moment. This rise has fueled the shortage of veterinary radiology professionals, especially in academia a favour By professional associations including the American College of Veterinary Radiology.

AI tools are developed with a technology known as deep learning, which in the case of radiology, trains them to identify abnormalities that may indicate disease. Training involves feeding the AI ​​a large number of radiographs. The process is refined through reviews by radiologists and user feedback.

Mars said it drew on the knowledge of Antech’s 123 radiologists to develop a trained AI with a slew of images stored by VCA, the US veterinary company it acquired in 2017.

“VCA data has been stored for nearly 20 years, and we have roughly 11 million or 12 million chips that we’ve trained AI on,” said Paul Fisher, senior vice president at Antech Imaging Services.

Fisher sees this technology as more of a friend to radiologists than a competition, at least in the near term. “I think it would make them more efficient with the assisted readings, but I really can’t see – for sure for a number of years – that he will replace the radiologist.”

The adoption of AI technology may increase the demand for supervision by humans through specialized training in radiology, according to Dr. Alistair Cliff, vice president medical at IVC Evidensia.

“I am very clear about this: I think veterinary radiologists should be excited about this product,” Cliff said. “They should be excited because what we’re basically doing is sparking a conversation about rays in a much larger group of animals than we’re currently doing.”

Academic research and anecdotal evidence point to this Cliff says vets usually provide X-rays for a radiologist’s opinion in about 5% to 10% of cases, possibly less. AI technology, by offering general practitioners a cheap and fast analytical tool, could introduce more pet owners to radiology, he asserts, which could prompt some to seek specialists to evaluate initial AI-based findings. “We see this as something that will do nothing but support the community of radiologists and, dare I say, shed light on them.”

Accuracy question

Prior to its rollout, IVC Evidensia tested SignalPET in 22 UK practices for up to 12 weeks, during which time it measured a number of performance factors including the accuracy of the tool, its impact on clinical care, and how satisfied vets and pet owners were with it. its performance. IVC Evidensia’s analysis indicated 95% accuracy – based on recognition of what is normal or abnormal in the radiograph – which happens to match the level of accuracy claimed by product developer SignalPET.

As for the impact on clinical care, Cliff said The use of the product in experimental practices has led to an increased use of other diagnostic equipment, such as Endoscopy and ultrasound. Pets eventually spent less time in the hospital, and frequent visits declined, suggesting that AI led to more targeted care, leading to better clinical outcomes. The vets were apparently impressed: 95% of the practitioners in the 22 experimental practices said they approved the product, while the remaining 5% said they hadn’t used it long enough to be sure, Cliff said.

Users of the AI ​​radiology tools contacted by VIN News last year gave mixed assessments of their abilities, ranging from enthusiastic praise to questioning their accuracy or applicability to certain conditions. Happy clients recounted occasions when the program picked up on occasional circumstances that might otherwise have been overlooked. Others said the products were particularly useful to younger colleagues as a learning tool. However, critics claimed that the AI ​​produced readings that were not specific enough or identified non-existent lesions.

Manufacturers assert that their accuracy claims are backed by academic research. In one of the most modern papersPosted in January in Veterinary Radiology and Ultrasound, AVCR Journal, Researchers at Tufts University evaluated the accuracy of Vetology in 41 dogs with confirmed pleural effusions (the buildup of excess fluid around the lungs). They found the technology’s accuracy rate to be 88.7%, concluding that the technology “appears to be valuable and needs further investigation and testing”.

Product developers acknowledge that their offerings are not perfect, although they stress that the quality of radiographs displayed on AI in general practice settings may not always be as good as radiographs provided by professionals or academics conducting research. “Explanations are only as good as they are given to the AI ​​to analyze,” said Eric Goldman, president of Vetology.

Goldman said the quality of images uploaded to AI software by veterinary professionals will depend on various factors, such as the patient’s posture, lighting levels and the presence or absence of obstructions.

“The other thing I would say is that the software doesn’t know that an animal is vomiting, that an animal has diarrhea, and the animal Coughing“,” He said. “The software can look at a well-positioned, well-taken radiograph and tell if it’s a heart or lung problem, but it has to match the clinical signs and it has to match the DVM’s training and experience. That’s why, after all things considered, we believe that humans And artificial intelligence goes better together.”

To this end, Vetology has developed a version of its artificial intelligence tool that is designed for radiologists, using language and technical concepts with which they are most familiar. It is currently being used by radiologists in the company’s teleradiology business for initial evaluations. “We don’t want to be comprehensive with technology and we want radiologists to be a part of it,” Goldman said.

Mars executives note that the process used to develop AI tools isn’t perfect either. Antik Fisher said he was trained by humans, who can make mistakes. “And that’s why we use a group of radiologists to train him every day – although as everyone probably knows, radiologists don’t always get along with each other.”

Diane Wilson Director of Scientific and Academic Affairs at Antech Imaging Service, notes that with 20 years of VCA data, its AI can encounter a lot of inconsistency and still produce accurate readings. She added, “I think one of the biggest limitations is the education of the end user. This is not a mechanical radiologist. It’s a machine that does a diagnostic test.” It is important that vets who may use them understand What he can and cannot do.

Likewise, Cliff of IVC Evidensia recommends veterinarians view AI radiology tools as an aid rather than an authority. “It forms part of a jigsaw puzzle that is a diagnosis,” he said. “It’s not a diagnosis per se.”

How advanced and autonomous AI products become remains an open question, not just in veterinary and human medicine, but in industries ranging from retail to the arts.

Dr. Debra Bird, Indiana-based Veterinary Radiologist and Diagnostic Imaging Consultant in the Veterinary Information Network, an online community for the profession, He doubts AI will ever get people like her out of their jobs. “Inclusion of radiographic findings or detecting abnormalities is one thing, but the interpretation and significance of the results is where I believe AI will not be able to replace the human brain,” she said.

VIN News Service comments are opinion articles that provide personal insights, experiences and/or perspectives on topical issues by members of the veterinary community. To submit a comment for consideration, send an email to news@vin.com.

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